Hands Across Canberra Project Support Application May 2017

Project SupportApplication – May2017

Working with ACT community organisations to make a difference.

Thank you for your interest in Hands Across Canberra. This Project Support Application Form is for requests between $1,000 and $10,000and is to be submitted by Monday, 22 May 2017. In exceptional circumstances grants in excess of $10,000 are available.

Please read the separate Terms and Conditions document carefully and answer ALL questions in the Application Form below. All organisations considering applying are encouraged to contact Hands Across Canberra to discuss your project or for any assistance –please email or callPeter Gordon on 0417064767.

Organisations are encouraged to submit applications for projects that assist it to meet its highest priorities of need. Organisations may submit more than one application if there are competing areas of demand that are serviced by the organisation. Hands Across Canberra also accepts applications at any time throughout the year.

Project Support Application Form

All questions are required to be completed.

ORGANISATION DETAILS
Name of Organisation:
Physical Address:
Postal Address:
Website Address:
Number of staff:
Number of volunteers:
Other resources:
Australian Business Number:
Tax Status
ATO Deductible Gift Recipient Item 1 (DGR1): Yes No (please delete one)
ATO Tax Concession Charity (TCC): Yes No (please delete one)
Registered for GST: Yes No (please delete one)
Contact details for Chief Executive Officer (or equivalent):
Name:
Title:
Telephone:
Email:
Contact person for Application (if different from above):
Name:
Title:
Telephone:
Email:
Organisation’s purpose, objectives and core services/products: (Please provide a brief overview of what your organisations does and its main outcomes – approximately 200 words)
PROJECT DETAILS
Project Title:
Start date:
Completion date (must be before 31 December 2018):
Total Project cost:
Amount requested:
What resources are required to complete the project most effectively?
If you are not seeking financial support, please specify how Hands Across Canberra can help with support such as in the areas of governance (for example, new skilled board members), accessing volunteers, applying for tax exempt status etc.
Brief project description: (please provide a short summary of your project – approximately 100 words)
Detailed project description: (Please outline the specific issue/challenge/need that the project will address and how this need was identified- approximately 200 words)
Who will the project help and how will they benefit? (please provide details on the number of people and their demographics – approximately 100 words)
What are the specific activities that will be undertaken to complete the project and address the need?
(Approximately 200 words)
What are the aims and objectives of the project?(Approximately 200 words)
What are the expected outcomes of the project over the short, medium and longer terms? (Please outline the difference this project will make – approximately 200 words)
How will you know if these outcomes have been achieved? (Please outline the measures of success and the evaluation process – approximately 200 words)
Are you aware of any other organisations undertaking a project with similar aims? If yes, please provide details and your view of whether this duplication is an issue or not (Approximately 200 words)
Why is Hands Across Canberra support essential?
Have you asked for support for the same project from other sources, and if so, what are the details?
PROJECT BUDGET
In this section, you are required to outline the project budget including details of other sources of funding and resources that have been confirmed and applied for. The budget must be balanced (i.e. total income = total expenditure). Please insert additional lines as required
INCOME / $
Amount requested in this application
Other funding sources
Confirmed funding (list funding sources and confirmed amounts, including your cash contribution)
Unconfirmed funding (if you have applied for other funding that is unconfirmed please list the name of the organisations applied to and amount)
In-kind contributions (include an estimated value for non-cash contributions such as services, equipment, time and material required to complete the projects)
TOTAL INCOME
EXPENDITURE
(Breakdown of individual line items required to complete the project such as salaries, equipment, travel/transport, administration etc.) / $
In-kind contributions (as for above)
TOTAL EXPENDITURE

Attachments:

Please provide the following documents with your application:

  1. Copy of the organisation’s latest financial statements and/or latest Annual Report
  2. Copy of a statement of other sources of funding for the project
  3. Evidence of the organisation’s status as a tax deductible gift recipient
  4. Copy of any other relevant documents to support the application (for example, research, media clippings)

Acknowledgement:

Ticking this box confirms that:

  • I have read and accepted the terms and conditions to seek funds from Hands Across Canberra;
  • I have responded to all sections and questions in the application form;
  • The organisation is registered on the Hands Across Canberra website, and
  • I acknowledge that the tax status of the organisation is relevant to this application.

Submitting your application:

The application is to be submitted in Word or PDF format by MONDAY, 22 MAY 2017.

Please email the application and attachments to:

If you have any problems or questions please call Peter Gordon on 0417064767 or email .

Receipt of applications is acknowledged by email. The applications will be assessed by our Board and Hands Across Canberra endeavours to notify grant seekers whethertheir request will be progressed within 30 working days after the closing date. In some cases, Hands Across Canberra will request furtherinformation. Please be mindful that Hands Across Canberra reserves the right to seek assistance from external experts in assessing applications.

Copyright © Hands Across Canberra 2017

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